HomeMy WebLinkAbout2-47-0647
r
60 j.
STATE OF FLORIDA
�PARTMENT OF HEALTH & REHABILITA& SERVICES
G
, y 7
41a�
VITAL STATISTICS
APPLICATION FOR BURIAL — TRANSIT PERMIT
A. (Type or Print)
1. Name of First Middle Last
Deceased
DATE
OF
Month
Day Year
RUTH R. SCHUSTER
DEATH
March
21, 1982
1. mace of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Vero Beach Inst. Indian River Memorial Hospital
3. Name of Medical ® Physician Address
Certifier Michaela Tovatt, M.D. ❑Medical Examiner 2300 Fifth Avenue, Vero Beach, Fla. 32960
4. Funeral Home/ Name Address
EXXXXf000sex Cox- Gifford - Romani, P.A. 1950 20th Street, Vero Beach, Florida 32960
5. Check a The medical certification has been completed and signed. A completed certificate of death accompanies
Appro- this application.
priate b T
l
h
Micaea ovatt
Box ® was contacted on 3/21182. He /she verified that
this de Ski ewas from natural causes, that there was no accident nor other external cause of death, and that
(t
cause of death. will complete and sign the medical certification of
c ❑ was contacted on . He /she verified that
medical certification. Medical Examiner, will complete and sign the
6. Funeral Director/ Signature Fla. Lic. No. /R XN)fi. Date Signed
�x�cX �fi7PiFi�X
William G. Romani #1550 March 22, 1982
B
BURIAL — TRANSIT PERMIT
Permit No. 5 -071 -19A2
Permission is hereby granted to dispose of this body.
A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and
granted. If it cannot be filed within this time limit, a "Funeral Director /Direct Disposer Report" will be filed
with the Local Registrar of the County in which death occurred.
c.
Registrar or
Sub- Registrar Signature ,,21
Date
Issued
C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL —AT —SEA
March 22, 1982
Signature Medical Examiner Date
or
Medical Examiner, gave authorizatidn by telephone to
Funeral Direci6r /Direct Disposer. Date
The Medical Examiner's approval must be obtained before dispgsal by any of the above methods. A waiting period of 48 hours after death
is required for all cremations. +
D. CEMETERY OR CREMATORY
Method of Disposition:
�J BURIAL 0 STORAGE
CREMATION F] OTHER (Specify)
Signature of Sexton ► Vif` / -'
or Person -in- Charge ► l�✓��
PlaceofDispositionSebastian Cemetery
S Date of Disposition 3,19 Q,i a Z
This permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton)
and returned within 10 days to the local County Health Department in the County where disposition occurred.
HRS Form 326, APR. 81
(replaces previous editions which may be used.)
Unit #2 Add., Blk. 47, Lot 6 & 7
Paid by General Receipt No. ...30.2 ... Dated ........3. -.22..-..82...... Schuster, Ratjzwnd H.
729 Spire Avenue
List Price $. Z.$Q..O.Q.Each Maximum No. Burial spaces ............ Sebastian, Florida 32958
— 0 * **
Discount $ .................. Total area in square feet ................ DEED # 488
Net Paid $.$ 300 .00.... _ .. Monument permitted . F.lat..... • . • ... • • .
R & R ISSUED WITH DEED
(Data above this line for City Record only)
BLOCK 47
LOT 6 & 7
RAYMOND H. SCHUSTER
729 SPIRE AVENUE
SEBASTIAN, FLORIDA 32958
(Ruth Interred 3- 24 -82, Lot #6)
RAYMOND H. SCHUSTER
729 SPIRE AVENUE
SEBASTIAN, FLORIDA 32958
LOTS 6 & 7
BLOCK 47
UNIT #2, ADDNT.
DEED # 488
DEED # 488
UNIT #2 ADDTN.
Ruttier Schuster Interred 3 -24 -82
-Lot 6
• •
30F
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
J ✓1p Dollars ($
.r✓10 ; )
FROM: l�%J /_ _,� „ 12 �/ i zz, (1i A J
on this — day ofz&&d,,L, 1982 for the purchase of the following
described Cemetery Lot(s) upon the terms and conditions as stated herein:
Description of Property:
Cemetery Lots) # 4 f- 2'- B1ock# Unit# a Q &�U
Purchase Price: �JDol1ars($ %20Q )
J
Terms and'conditions of sale:
This contract shall be binding upon both parties, the seller and the purchaser, when
approved by the owner of the property above described.
I, or we, agree to purchase the above described property on the terms and conditions
stated in the foregoing instrument:
The City of Sebastian agrees to sell the above mentioned property to the above named
purchaser(s) on the terms and conditions stated in the above instrument.
y of Sebastian
Witness
Artistry in m
Memorials `I
Merritt Monument Company, Inc.
4820 South U. S. Highway 1
Fort Pierce, Florida 33450
Phone: 464 -5547 or 464 -3755
April 19, 1982
Granite - Marble
Bronze
FOR APPROVAL
SEBASTIAN CEMETERY paid ck #10086 - $45.00
CITY OF SEBASTIAN
SIZES 44" x 13" Bronze set in 48" x 17" Granite Mount
NAME s
RAYMOND H.
1914 - blank
SCHUSTER
LEGAL DESCRIPTION
SECTIONs A2 �
BLOCKS 47
LOTs 6 & 7
SPACEs
SQUARE FEET
CHECKED BY
BY
MERRITT MONUMENT CO.,INC.
4820 SOUTH US 1
FT. PIERCE,FL. 33454
RUTH R.
1919 - 1982
APPROVED-/-
DATE
'THEY HAVE NOT BEEN FORGOTTEN"